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Single Implant–Supported Prosthesis Is a Viable Treatment Option in Female Patients with Primary Sjögren's Syndrome
TAKE-HOME MESSAGE
- This prospective clinical study assessed the prognosis of single implant–supported prostheses in female patients with primary Sjögren's syndrome (pSS). Compared with the control group, as expected, the decayed-missing-filled tooth score was higher in patients with pSS. At the same time, both the unstimulated and chewing-stimulated saliva flow rates were significantly lower in patients with pSS. At the implant sites, no difference was noted concerning implant survival rates, probing depths, and plaque index scores between the control and pSS groups. By contrast, the gingival index score was higher in the pSS group. After 5 years, the mean marginal bone loss, prosthetic complication rates, and clinician-reported esthetic outcomes were similar in both groups. Oral health–related quality of life measures following treatment were significantly higher in the pSS group.
- A single implant–supported prosthesis appears to be a viable treatment strategy in female patients with pSS. The limited sample size is an important limitation of this study.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Primary Sjögren's syndrome (pSS) is a chronic systemic autoimmune disease characterized by hyposalivation. Currently, there is limited evidence for the prognosis of dental implant treatment in Sjögren's syndrome.
AIM/HYPOTHESIS
We hypothesized comparable clinical outcomes of implant-supported restorations in pSS-patients and control subjects, and improvement in oral health-related quality of life 5 years after restoration.
MATERIAL AND METHODS
Patients with pSS and matched (age, gender, and tooth region) control group were recruited between June 2016 and March 2020. The clinical and radiological examination were performed, and patient-reported oral health impact profile (OHIP-49) questionnaire was used 2 months (baseline), 1, 3, and 5 years after prosthetic treatment.
RESULTS
We included 23 patients with pSS and 24 matched control subjects (all women, mean age: 57.1 years). The overall DMFT (decayed-missed-filled-tooth) was significantly higher (p = 0.008), symptoms of dry mouth were more severe (p = 0.001), and unstimulated and chewing-stimulated saliva flow rates were significantly lower (p < 0.001) in pSS than in control group. All implants survived with no implant mobility. At implant sites, the plaque index and probing depths did not differ (p = 0.301 and 0.446, respectively), but the gingival index was significantly higher (p = 0.003) in pSS than control group. The mean marginal bone loss, prosthetic complications, and clinician-reported aesthetic outcomes were similar in both groups after 5 years. The OHIP scores were significantly higher in the pSS than control group (p < 0.001) but reduced significantly in both groups (p = 0.026).
CONCLUSION
Replacement of missing single teeth with dental implants was successful in patients with pSS 5 years after restoration.
Additional Info
Disclosure statements are available on the authors' profiles:
Prognosis of Single Implant-Supported Prosthesis in Patients With Primary Sjögren's Syndrome: A Five-Year Prospective Clinical Study
Clin Oral Implants Res 2024 Sep 05;[EPub Ahead of Print], M Hosseini, SS Jensen, K Gotfredsen, E Hyldahl, AML PedersenFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Patients with Sjögren's syndrome are challenging to manage because of hyposalivation, creating a high caries risk environment. This study evaluated 23 patients with Sjögren's syndrome and 24 controls who received a single bone-level implant-supported prosthesis and were followed up for 5 years. Control patients were matched for age, sex, and implant position. Clinical and patient-reported outcomes for both groups were collected at baseline and 1, 3, and 5 years.
Clinical findings showed no significant differences in marginal bone loss, prosthetic complications, plaque index, or probing depth between the groups. However, patients with Sjögren's syndrome had a significantly higher gingival index, indicating more inflammation around the implant. The inflammation remained stable over time. The authors attributed the inflammation to hyposalivation, resulting in impaired oral clearance and microbial dysbiosis.
Both groups reported a noticeable improvement in the overall oral health–related quality of life after the implant was restored. Patients with Sjögren's syndrome reported a lower oral health–related quality of life than the control group before treatment and at recalls.
It is important to note that patients with Sjögren's syndrome are often taking medications such as corticosteroids or immunosuppressants that have been thought to impair healing and osseointegration. Patients with Sjögren's syndrome in this study were carefully selected based on good compliance, sufficient bone volume, and adequate interarch space. This 5-year prospective cohort study demonstrates that patients with Sjögren's syndrome can be suitable candidates for single implant treatment.